Objective To explore the influence of MMF on the presentation functions of in vitro cultured dendritic cells.Methods Bone marrow-derived dendritic cell progenitors from BalB/c mice were treated with MMF or without. The antigen-presenting capacities, antigen specific proliferation reaction, mixed lymphocyte reaction and antigen-specific hyporesponsiveness of T-cells were analyzed to investigate the influences of MMF on the presentation functions of dendritic cells.Results Treatment with MMF reduced the soluble antigen presenting capacities of DCs to T cells. The proliferation of syngeneic T cells co-cultured with MMF-DC was significantly depressed, and displayed a comparatively low level of MLR-sti- mulatory activity. The levels of T helper cells derived cytokines were depressed, too.Conclusion MMF has a suppressive influences on the antigen-presenting functions of in vitro cultured dendritic cells and promotes the tolerance-induction effect of DCp.

Objective To discuss the clinical values of 18 F-FDG imaging in screening of the recipients with liver transplantation.Methods By using positron emission tomography, 16 case of hepatocellular carcinoma and 21 case of hepatic cirrhosis with discompensation were subjected to 18 F-FDG imaging. The obtained images were fused with CT images. According to the result of the abnormal 18 F-FDG uptake in 18 F-FDG imaging and image fusion with CT imaging, extrahepatic malignant tumor was judged. The initial routine examinations showed no extrahepatic malignant tumor in these 37 cases , including primary extrahepatic carcinoma and extrahepatic metastasis of liver carcinoma.Results Among the 21 case of hepatic cirrhosis with discompensation, there were 5 cases of extrahepatic primary carcinoma and metastasis. In 16 cases of primary hepatocellular carcinoma, there were 7 cases of extrahepatic metastasis.Conclusion 18 F-FDG positron emission tomography imaging can find the extrahepatic carcinomas which can not be discovered by other examinations, which can provide more information for screening of the recipients undergoing liver transplantation.

OBJECTIVE To investigate the application of blood test in the prognosis of nasal NK/T-cell lymphoma.METHODS The clinicopathologic and follow-up data of 62 patients with nasal NK/T-cell lymphoma proven by pathological examination were collected.The blood lactic dehydrogenase(LDH),globulin(GLB),albumin(ALB),hemoglobin(Hb),and white blood cell(WBC) were examined in these patients.The correlation between these factors and prognosis were analyzed with univariate analysis and multivariate analysis.RESULTS Of the 62 patients,47 were males and 15 were females.Their median age was 42 years.Ninety two percent of the patients were in Ann Arbor I/Ⅱ stage,and 76 % had international prognostic index(IPI) of 0 or 1.Before treatment,92 % of the patients had ECOG performance status(PS) score of 0-1,26 % had anemia,53 % presented B symptoms.The median overall survival time was 27 months(95 % CI:10-45months).In univariate analysis,gender,age,PS score,LDH,IPI,B symptoms,Hb and WBC were statistically significantly correlated to the prognosis.In multivariate analysis,Hb1 were statistically significant unfavorable prognostic factors.CONCLUSION Hb together with B symptoms and PS score may be independent prognostic factors for nasal NK/T cell lymphoma.

OBJECTIVE: To investigate the clinicopathological features and prognostic factors of nasal NK/T-cell lymphoma. METHOD: The clinicopathological data, treatment modality and survival status were analyzed. RESULT: The overall five year survival rate of: 62 patients was 63.5%. In univariate analysis, the prognosis of the patients was correlated with the age, perforation, B symptom, stage, Hb concentration, LDH level, size of tumor cell, number of involvement sites, angioinvasion and treatment modality (P < 0.05 or P <0.01). In multivariate analysis, the Hb concentration, the size of the tumor cell and the treatment modality were the independent prognostic factors. CONCLUSION The Hb concentration, the size of the tumor cell and the treatment modality play key role in the prognosis of nasal NK/T-cell lymphoma.
Adolescent ; Adult ; Aged ; Female ; Humans ; Lymphoma, Extranodal NK-T-Cell ; diagnosis ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; Nose Neoplasms ; diagnosis ; pathology ; Prognosis ; Survival Rate ; Young Adult

OBJECTIVE: To investigate the significance of expressions of p53 and p21 in nasal NK/T-cell lymphoma (NKTL) and their relationship with cell proliferation and apoptosis. METHOD: Sixty-two cases of NKTL were examined for p53, p21 and Ki67 proteins by means of tissue microarray technique, TUNEL and immunohistochemistry. The proliferation index (PI) was determined by expression of Ki67 proteins. RESULT: The positive expression rates of p53 and p21 proteins in NKTL were 79.03% and 58.06% respectively. The positive expression rates of p53 in Ann Arbor stage I, II, III and IV NKTL were 69.57%, 75%, 86.67% and 100% respectively, while those of p21 were 47.83%, 56.25%, 60% and 87.50%. With the progression of tumor, the positive expression rates of p53 and p21 proteins gradually increased. And there were significant differences between them (P<0.05). The positive expression rates of p53 in NKTL with large, medium and small size tumor cells were 92.86%, 78.95% and 53.33% respectively, while those of p21 were 67.86%, 57.89% and 40.00%. With the expanding of tumor cells, the positive expression rates of p53 and p21 proteins gradually increased. And there were significant differences between them (P<0.05). The expression of p53 was positively correlated with the expression of p21 (P<0.05). The intensity of p53 and p21 expression, the Ann Arbor stage and the size of tumor cell all were positively correlated with PI (Spearman correlation analysis, P<0.05), while no correlation with AI (P>0.05). CONCLUSION The expressions of p53, p21 and Ki67 proteins are closely related with the pathogenesis and progression of NKTL. Combined detection of p53, p21 and Ki67 is a good marker to judge the biological behavior of NKTL, such as the proliferation and the invasiveness of the tumor.
Adolescent ; Adult ; Aged ; Apoptosis ; Cell Proliferation ; Cyclin-Dependent Kinase Inhibitor p21 ; metabolism ; Female ; Humans ; Ki-67 Antigen ; metabolism ; Lymphoma, Extranodal NK-T-Cell ; pathology ; Male ; Middle Aged ; Tumor Suppressor Protein p53 ; metabolism ; Young Adult

OBJ ECTIVE To introduce adjusted limited dependent variable mixed model （ALDVMM）and study its application in mapping research ，so as to provide reference for pharmacoeconomic evaluation that needs to obtain health utility value through mapping. METHODS Using the method of literature research ，ALDVMM was introduced from the aspects of development background，model principle ，model determination and test ，model advantages and the current application of the model in empirical research. RESULTS & CONCLUSIONS ALDVMM is a mixed model developed by foreign scholars for the truncation and multimodality phenomenon of EuroQoL group ’s 5D（EQ-5D）at the health utility value 1. Compared with the traditional model，ALDVMM is feasible and has more advantages ，and can more effectively and flexibly capture the actual distribution of EQ-5D and deal with the boundary value problem ，which is helpful to obtain the health utility value more accurately and efficiently and carry out high-quality pharmacoeconomic evaluation.

OBJECTIVE：To inve stigate the current situation of clinical pharmacists ’job stress and presenteeism behavior in tertiary hospitals of China and study their correlation. METHODS ：Using the Brief Job Stress Questionnaire （BJSQ）and the presenteeism behavior individual questionnaire ，a survey of 623 clinical pharmacists in 311 tertiary hospitals from 31 provinces in China was conducted ；by establishing Logistic model between job stress ，its various dimensions （job demand ，job control ， support）and presenteeism behavior ，the correlation analysis was performed for their survey results. RESULTS ：The average job pressure of the interviewed clinical pharmacists was 36.75 points；the probability of presenteeism behavior was 20.38％. Logistic regression model analysis results showed that job stress and its two dimensions （job demand ，job control ）had a significant positive correlation with presenteeism behavior （P＜0.05）. CONCLUSIONS ：The job stress of clinical pharmacists in tertiary hospitals in my country is relatively high ，which is also the main reason for their presenteeism behavior. Job stress can be reduced （such as increasing the staffing appropriately ，providing reasonable rest time ，improving the job substitution of clinical pharmacists ）to reduce the prevalence of presenteeism behavior.

Objective:To investigate the application value of carbon nanoparticle tracer in lymph node dissection for Siewert type Ⅱ and Ⅲ adenocarcinoma of esophagogastric junction (AEG).Methods:The retrospective cohort study was conducted. The clinicopathological data of 147 patients with Siewert type Ⅱ and Ⅲ AEG who were admitted to Shengli Petroleum Central Hospital from June 2015 to July 2020 were collected. There were 109 males and 38 females, aged (65±9)years. All the patients underwent laparoscopic-assisted radical resection of AEG via esophageal hiatus. Of 147 patients, 61 cases not injected with carbon nanoparticle tracer preoperatively were allocated into control group and 86 cases injected with carbon nanoparticle tracer preoperatively were allocated into experimental group. Observation indicators: (1) surgical and postoperative situations; (2) influencing factors analysis of No.10 lymph nodes metastasis. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Count data were represented as absolute numbers or percentages, and comparison between groups was analyzed by the chi-square test. Univariate analysis was conducted by statistic methods based on data type, and multivariate analysis was conducted by the Logistic step-wise regression model. Results:(1) Surgical and postoperative situations. Patients of the experimental group and control group completed laparoscopic-assisted radical resection of AEG via esophageal hiatus successfully. There was no significant difference in the operation time, volume of intraoperative blood loss, the total number of lymph node dissection, the number of the first station, the second station and positive lymph nodes between the two groups ( P>0.05). For the experimental group, the black staining rate of lymph nodes was 57.937%(1 365/2 356), the black staining rate of the first station and second station lymph nodes was 77.989%(1 024/1 313) and 43.691%(232/531), the black staining rate of Siewert type Ⅱ and Ⅲ AEG patients was 56.855%(423/744) and 58.437%(942/1 612), respectively. The lymph node metastasis rate was 19.091%(815/4 269) of 147 patients, 18.573%(242/1 303)of Siewert type Ⅱ AEG patients and 19.319%(573/2 966) of Siewert type Ⅲ AEG patients. For Siewert type Ⅱ AEG patients, the metastasis rate of No.1, 2, 3, 4sa, 4sb, 7, 8a, 11p lymph nodes was more than 10%, the metastasis rate of No.4d, 5, 6, 9, 10, 11d, 12a lymph nodes was lower than 10%. For Siewert type Ⅲ AEG patients, the metastasis rate of No.1, 2, 3, 4sa, 4sb, 7, 8a, 10, 11p and lower mediastinal lymph nodes was more than 10%, the metastasis rate of No.4d, 5, 6, 9 11d, 12a and lower mediastinal lymph nodes was lower than 10%. There was no significant difference in the Clavien Dindo classification of postoperative complications between the two groups ( P>0.05). (2) Influencing factors analysis of No.10 lymph nodes metastasis. Results of multivariate analysis showed that tumor T staging and degree of tumor differention was an independent influencing factor for No.10 lymph nodes metastasis ( P<0.05). Conclusions:For Siewert type Ⅱ and Ⅲ AEG patients, the application of carbon nano-partide tracer can not increase the number of lymph node dissection. The second station lymph node dissection should be paid attention for Siewert type Ⅱ AEG. Tumor T staging and degree of tumor differentiation are independent influencing factors for No.10 lymph nodes metastasis.

OBJECTIVE To boost access to medical insurance for drugs and improve the accessibility and affordability of drugs. METHODS The current status of the application of international and domestic drug Managed Entry Agreement （MEA）were investigated through literature research method and other methods ，and analyzed comparatively from the aspects of the scope of agreement drugs ，the types of agreements and the content of the agreement ，etc. The problems existing in the application of drug MEA in China were summarized to put forward the suggestions. RESULTS & CONCLUSIONS The UK ，Australia and Italy had rich experience in the application of drug MEA ，and the operation management mechanism were complete. The scope of drugs included in MEA in these countries were relatively broad and the types of agreements were relatively diversified. In China ，drugs included in MEA were mainly oncology drugs and rare disease drugs. The types of agreements mainly included “finance-based agreements”and effect guarantee/effect-based payment in individual-level of“performance-based agreements ”. China ’s evidence collection platform was imperfect and lacked standardized process of MEA. It is suggested that stakeholders should consider increasing the types of drugs ，diversified types of agreements ，improving the accuracy and continuity of evidence collection ， establishing a standardized process for MEA.

ABSTRACT OBJECTIVE：To analyze the job stress of hospital pharmacists and its measurement methods，and to provide reference for improving the quality of related researches about the work stress of hospital pharmacists. METHODS：Related literatures about the job stress of hospital pharmacists were retrieved from CJFD，VIP，Wanfang database，Web of Science， SciFinder，Springer Link and other databases during database establishment to Aug. 2019，using“Hospital”“Pharmacist”“Stress” “Scale”as Chinese keywords，“Hospital”“Pharmacist”“Stress”“Pressure”“Scale”as English keywords. The research status was explored，and the measurement methods for work stress of hospital pharmacists were summarized. RESULTS：There were many researches on the job stress of pharmacists at abroad，including the stress status，causes，the results of stress，the model of action mechanism，etc.，but there were some problems such as long time ago and outdated data；while the related researches in China were relatively rare，and there was still a lack of comprehensive and systematic research on the job stress of hospital pharmacists. Most researches at home and abroad used the scale to measure job stress of hospital pharmacists，including the special scale for hospital pharmacists（such as the pressure source scale and the pressure list of hospital pharmacists）and the general scale for general employees（such as health occupational stress survey，work stress items and perceived psychological stress scale）. Among them，pressure source scale of hospital pharmacists was relatively consistent with the job characteristics of hospital pharmacists in China，while the other scales had problems of less coverage，too many items，and not conforming to job characteristics of hospital pharmacists in China. CONCLUSIONS：In order to improve the research quality related to job stress of hospital pharmacists，it is necessary to adjust the existing scale or develop a new measurement scale in order to measure the real work pressure of Chinese hospital pharmacists and provide reference for improving the quality of work of hospital pharmacists and improving the level of clinical pharmaceutical care